title: Radiobiological advantages of an immediate interstitial boost dose in conservative treatment of breast cancer.
abstract: Minimum surgery with irradiation is emerging as one of the main modalities of therapy for operable early breast cancer. Between June 1982 and June 1986, 110 breasts with Tis, T1 to T3 lesions have been treated at our institution with lumpectomy and interstitial irradiation to the tumor bed with Iridium-192 perioperatively followed by external beam irradiation. There have been two local recurrences at or near the vicinity of the primary, at a median follow-up of 60 months. To analyze the parameters that might have contributed to the local control, we have examined the treatment volumes, prescribed dose to the tumor bed, dose at the core of the tumor bed, and dose to the surrounding normal tissue. Immediate interstitial implant has the radiobiological advantage of delivering continuous low dose irradiation, immediately upon removal of gross tumor to residual foci. Implantation of the afterloading catheters intraoperatively facilitates accurate dose delivery and avoidance of geographical misses. By precise treatment of any residual foci, immediately upon removal of the gross mass, perioperative interstitial irradiation improves local control and by facilitating less radical surgical excision, leads to better cosmetic results.
authors.affiliation: Dept. of Surgery, University of Kansas Medical Center, Kansas City 66103.
authors.forename: E C
authors.initials: EC
authors.lastname: Krishnan
authors.forename: L
authors.initials: L
authors.lastname: Krishnan
authors.forename: E P
authors.initials: EP
authors.lastname: Cytaki
authors.forename: C D
authors.initials: CD
authors.lastname: Woolf
authors.forename: M M
authors.initials: MM
authors.lastname: Henry
authors.forename: F
authors.initials: F
authors.lastname: Lin
authors.forename: W R
authors.initials: WR
authors.lastname: Jewell
mesh_terms: D001918:Brachytherapy; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D015412:Mastectomy, Segmental; D013997:Time Factors
chemical_list: D007496:Iridium Radioisotopes